The activation of proteins by post-translational modification is an important cellular mechanism for regulating most aspects of biological organization and control, including growth, development, homeostasis, and cellular communication. Protein phosphorylation, for example, plays a critical role in the etiology of many pathological conditions and diseases, including cancer, developmental disorders, autoimmune diseases, and diabetes. Yet, in spite of the importance of protein modification, it is not yet well understood at the molecular level, due to the extraordinary complexity of signaling pathways, and the slow development of technology necessary to unravel it.
Protein phosphorylation on a proteome-wide scale is extremely complex as a result of three factors: the large number of modifying proteins, e.g. kinases, encoded in the genome, the much larger number of sites on substrate proteins that are modified by these enzymes, and the dynamic nature of protein expression during growth, development, disease states, and aging. The human genome, for example, encodes over 520 different protein kinases, making them the most abundant class of enzymes known. See Hunter, Nature 411: 355-65 (2001). Most kinases phosphorylate many different substrate proteins, at distinct tyrosine, serine, and/or threonine residues. Indeed, it is estimated that one-third of all proteins encoded by the human genome are phosphorylated, and many are phosphorylated at multiple sites by different kinases. See Graves et al., Pharmacol. Ther. 82: 111-21 (1999).
Many of these phosphorylation sites regulate critical biological processes and may prove to be important diagnostic or therapeutic targets for molecular medicine. For example, of the more than 100 dominant oncogenes identified to date, 46 are protein kinases. See Hunter, supra. Understanding which proteins are modified by these kinases will greatly expand our understanding of the molecular mechanisms underlying oncogenic transformation. Therefore, the identification of, and ability to detect, phosphorylation sites on a wide variety of cellular proteins is crucially important to understanding the key signaling proteins and pathways implicated in the progression of diseases like cancer.
An important class of signaling proteins is the receptor tyrosine kinase family (RTKs), which act as essential mediators of physiological cell functions such as proliferation, differentiation, motility or survival. On the basis of their structural characteristics RTKs can be classified into 20 subfamilies, which share a homologous domain that specifies the catalytic tyrosine kinase function (Zwick et al., 1999 Trends in Pharmacological Sciences 20: 408-412). The RTKs include the epidermal growth factor receptor (EGFR) family, which consists of four closely related receptors: EGFR (HER1), HER2 (ErbB2/neu), the kinase dead HER3, and HER4 (ErbB4) (Casalini et al. (2004) J. Cell. Physiol 200: 343-350). Signaling through EGFR is an important component of normal development, and defective signaling through this receptor early in development can be detrimental for embryogenesis and organogenesis (see Casalini et al., supra.)
Aberrant EGFR activity has been implicated in a variety of human solid tumors including lung, bladder, breast, esophageal, head and neck, and gynecological tumors (Smith et al. 2004 Oncology Research 14, 175-225). Over-expression of EGFR has also been shown in 53% of malignant gliomas, and a mutated form of EGFR, the type III EGFR deletion mutant (also known as EGFRvIII), is frequently found in human glioblastomas, breast tumors, and meduloblastomas (see Smith et al., supra.). EGFR overexpression in non-small cell lung cancers (NSCLC) is correlated with shorter patient survival times as compared to patients with lower or normal levels of the receptor (Veale et al., 1993 Br. J. Cancer 68: 162-165).
EGFR, through its extracellular domain, binds to different ligands, including epidermal growth factor (EGF), tumor growth factor-alpha (TGFalpha), betacellulin, amphiregulin, epiregulin and heregulin (Riese et al. 1998 Bioassays 20: 41-48). Ligand binding induces homodimerization, leading to ATP-mediated autophosphorylation or transphosphorylation (by a partner kinase) of EGFR, which in turn activates its kinase function (Russo et al., 1985 J. Biol. Chem. 260: 5205-5208). Within EGFR, the sites reported to be most important in terms of receptor phosphorylation and activation are Tyr 1148, Tyr1173, Tyr1068, and Tyr1086 (Downward et al. (1984) Nature 311: 483-485; Margolis et al. (1989) J. Biol. Chem. 264: 10667-10671). Phosphorylation of these distinct tyrosine residues creates binding sites for numerous proteins, typically containing Src homology 2 (SH2)- and phosphotyrosine binding (PTB)-domains, many of which are either tyrosine phosphorylated enzymes, such as Src or Phospholipase C gamma, or adaptor molecules that link receptor activation to downstream signaling pathways including MAPK-Erk1/2 and PI3K-AKT (see Zwick et al.)
Despite the identification of some of the downstream targets and effectors of EGFR, the molecular mechanisms contributing to EGFR-mediated oncogenesis in a variety of human cancers remain incompletely understood. At the same time, however, interest in EGFR as a therapeutic target has continued to increase, and targeted inhibitors of this RTK are already on the market, or in clinical trials, for a variety of cancers involving activated EGFR. For example, Herceptin®, an inhibitor of HER2/neu, is currently an approved therapy for a certain subset of breast cancer. Iressa™ (ZD1839), a small-molecule inhibitor of EGFR, has recently entered clinical trials for the treatment of breast cancer, while another small molecule inhibitor, Tarceva™ (OSI-774), is in clinical trials for the treatment of non-small cell lung carcinoma (NSCLC). However, the efficacy, mechanism of action, and clinical utility of these compounds in mediating molecular effects downstream of EGFR remain to be seen. Indeed, the limited success thus far observed with these highly specific targeted inhibitors (each targeting only a single protein) evidences that additional signaling molecules beyond just EGFR may be driving these cancers.
For example, 30-50 percent of HER2-positive breast cancers do not respond to the HER2-inhibitor, Herceptin® (see Hortobagyi (2001) Semin Oncol 6, Suppl 18: 43-7). These observations, along with recent studies (with Gleevec® and Rapamycin) establishing that combinations of targeted therapeutics may be more effective than single agents (see Mohi et al., Proc Natl Acad Sci U.S.A. (2004), 101(9): 3130-5), support the widely-accepted belief that multiple signaling molecules are in fact driving most cancers.
Accordingly, there is a continuing and pressing need to unravel the molecular mechanisms of EGFR-driven oncogenesis by identifying the downstream signaling proteins mediating cellular transformation in diseases involving activated EGFR. Identifying particular phosphorylation sites on such signaling proteins and providing new reagents, such as phospho-specific antibodies and AQUA peptides, to detect and quantify them remains particularly important to advancing our understanding of the biology of these cancers.
Presently, a handful of compounds targeting EGFR are in or entering clinical trials for the treatment of various cancers, including breast and lung. Although the activation and/or expression of EGFR itself can be detected, it is clear that other downstream effectors of EGFR signaling, having diagnostic, predictive, or therapeutic value, remain to be elucidated. Identification of downstream signaling molecules and phospho-sites involved in the progression of EGFR-driven cancers, and development of new reagents to detect and quantify these sites and proteins, may lead to improved diagnostic/prognostic markers, as well as novel drug targets, for the detection and treatment of these diseases.